2

TOS:
Tos involves the lower portion of the brachial plexus, where nerves from the neck pass through a tunnel into the chest on the way to the arm. The plexus can get trapped in the outlet area, and this event can cause pain, numbness, tingling, weakness, but can also affect blood vessels. On occasion, a congenital first rib can cause compression but trauma may also promote tos.
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3

Narrowing of space:
Thoracic outlet syndrome is narrowng of the space between the first rib and the anterior scalene muscle. The axillary vein and artery and brachial plexus nerve passes through this space. Narowing the space can pinch the artery, vein, nerve or all of the above. Also, a rare, abnormal cervical rib can cause the same problems.
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4

Quite often:
Several centers of expertise thruout the usa now exist with surgeons possessing great experience. Success rates are approaching 80-85 % in carefully selected cases, whose preoperative testing is definitive. Excellent outcomes can be found at ucla, johns hopkins, washington univ. In st louis, and psl in denver, co.
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5

Not necessarily.:
Assuming that is correct diagnosis, this can commonly be helped with physical therapy. There may be necessity to consider surgical intervention for refractory symptoms, yet that surgery is commonly successful. This is a difficult diagnosis, to come to, so I would make sure you are comfortable with how you came to this diagnosis, and if not consider another opinion.
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6

Not very common:
Three manisfestations:
1. Pinching of the artery leading to the arm and hand (most common)
2. Pinching of the vein leading to the arm and hand, resulting in swelling (next common)
3. Pinching of the nerve resulting in various types of pain (not very common).
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8

Surgery:
Thoracic outlet surgery is done to remove pressure or compression of the nerve, artery, and vein going to the arm. This involves removing the first rib, and releasing any scar tissue present. This results in significant reduction in symptoms in most cases.
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9

No specific test:
Unfortunately, there is no specific "thoracic outlet syndrome test". There are a number of things that may lead your physician to consider this diagnosis, but quite frankly the diagnosis is often overlooked. Symptoms are pain above your collarbone or in the affected arm, but the process can also affect the vein and artery to the arm. Studies of the arteries and veins can confirm the diagnosis.
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10

Pain, numbness:
Thoracic outlet syndrome can affect the vein, artery or nerves of the arms. Symptoms can include swelling of the arms, (vein compression) pain or numbness when using the arms overhead, or pain that can extend from the neck or shoulder down to the hands or fingers. Most symptoms are aggravated by doing things that narrow the space where vein, atery and nerve travelling to the arm are.
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